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PT and the Greater Good

Prescribing Problems for the PT

Published November 23, 2010 12:03 PM by Dean Metz

A couple of weeks back I posted that I am actually able to prescribe medications in very particular circumstances. I thought that was very forward-thinking and praised the autonomy allowed to physiotherapists here.

Today we take a step backward. I had to sit through a class on prescribing standard wheelchairs. No, I'm not allowed to prescribe a wheelchair unless I have sat through this course, taught by nurses (ouch!), on how to measure people for selecting a standard chair. I learned this during my second year of PT school and have been doing it practically for two decades now. I was miffed. So now I am deemed qualified (aren't physiotherapists here taught about wheelchair prescriptions and fitting?) to issue standard and junior chairs. No hemi-chairs, no elevating leg rests, no desk arms. Those require a specialist's assessment. What am I, chopped liver?

To the credit of the instructors, they recognized my abilities, agreed that perhaps it was a bit ridiculous that I had to refer to them work I could clearly do myself. Ah but the bureaucracy that has their hands tied won't allow them to actually clear me to do that bit that I am qualified to do.

The NHS giveth and the NHS taketh away.


Very interesting the way tasks are divided differently among UK healthcare providers versus here.  Kudos to the nurses for recognizing your abilities, even though regulations prevent them from acting on that knowledge.  I had two thoughts reading this:

I wonder if we underutilize foreign healthcare workers when they come to the US?  Do we assume if US healthcare workers aren't trained to perform a given function, then the foreign healthcare worker isn't either.

I've heard of some places that cross train for certain responsibilities so that different departments are able to cross function to some degree.  Seems like in the UK and US, wheelchair fitting could be one of those responsibilities for therapy and nursing.

Okay, I thought of would be interesting to do a cross cultural study of healthcare workers throughout the world, seeing what responsibilities each discipline is trained for and which discipline, if any, is the primary discipline to deal with a given area of responsibility.

Janey Goude November 26, 2010 11:01 PM

This is funny only because it is bureaucracy at its best. Seems like you have made the best of it.  Too many therapists may have been really upset and spoken against this.  Actually for nursing this would be beneficial in some of the facilities I have been in.  Rather than constantly refer to PT to lengthen leg rests they could do it themselves with a cresent wrench.

Jason Marketti November 24, 2010 2:59 AM

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About this Blog

    Dean Metz
    Occupation: Staff Development Specialist
    Setting: New York, NY – Newcastle Upon Tyne, Great Britain
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